This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. The purpose of this study is to see if adding a drug called spironolactone with other drugs improves heart failure. The aims of this study are to test the safety and effect of spironolactone compared with placebo. This treatment is for adults with heart failure with the abnormal pumping function of the main pump of the heart. Spironolactone is a "potassium-sparing" water pill that removes extra water and prevents salt retention. Spironolactone is used to treat people with congestive heart failure. This drug is already approved by the Food and Drug Administration (FDA) for congestive heart failure. This study uses a lower starting dose of this drug that is not approved by the FDA and compares it to a placebo . This will test if the drug has a real effect.